Why then is the mortality from [breast cancer] so high? The answer is, that premature metastases have been established by massage.... A woman discovers a "lump" in her breast. She has heard that this is a very serious thing and naturally becomes alarmed. She continually feels of this lump to make sure that it is there. Often she asks her husband, or one of her friends, to feel of it. This, of course, amounts to massage. After a time she goes to her physician, who makes a "thorough" examination. Certainly, if he does his duty, he advises immediate consultation of a surgeon, who in turn adds his palpation to the tumor. Thus we see that in the natural history of most breast tumors there is considerable handling before the lesion is removed.... It is evident that the unfavorable results obtained in the treatment of cancer of the breast are due to premature metastases. These, most probably, are brought about by excessive handling of the tumor by the patient and very often by a too vigorous examination by the physician.